Jun 20 Tongue and Lip Tie Revision: Katharina's Seven Steps for Socking it to a Tie

Over the past three years, I’ve gone through the tongue and lip tie journey twice, once with each of my two boys. I know all about the worry and anxiety, that every mom feels before having her baby’s tongue or lip tie released.

My hopes and fears went hand in hand, each time my husband and I took our little baby to undergo this procedure. Whether you’re breastfeeding or bottle feeding, there are challenges and frustrations. I am by no means an expert, but I love sharing what I’ve learnt. Below I hope you find some moral support and some valuable insights.

1. Pain Relief

One of the biggest concerns may be whether your baby will experience any pain. Both my boys cried during the procedure; actually, the crying started when their little arms were wrapped up and the tiny goggles were put on to protect their eyes for the laser revision. They cried right up until they were back in my arms. Each time, I was so relieved and a little surprised to see them calm down so quickly. So, while I don’t know if my babies were in pain, they didn’t look in nearly as much pain after the release, as they did when cutting their teeth, especially those molars!

Mama Tip: Feed immediately after the procedure. This requires a bit or planning. Try to ensure that your baby will be “ready” to eat, but not yet “hangry” just before the procedure. If you plan to give your baby a bottle be sure to have this prepared and ready to go before hand. Talk to your provider ahead of time, and tell him that you’d like to feed your baby immediately following the procedure; right then and there in the same room. This way your provider can give you the time, space, and privacy.

I have heard of babies acting noticeably uncomfortable for about 24-48 hours after the procedure. In case this happens, discuss pain medications with your provider.

Mama Tip: Frozen breastmilk in a mesh-feeder works really well!

2. Stretch It Out

We all know how quickly a scrape on the knee or elbow heals up. Well, oral wounds heal that much faster. And because wounds under the lip and tongue are in constant direct contact, these wounds tend to heal “back together” or “reattach”. Stretching helps prevent this.

Mama Tip: Use a thin layer of coconut oil on your finger as a lubricator, helping your finger slide over the wound more smoothly.

While my boys didn’t seem uncomfortable after the procedure, they did fuss during the exercise stretches, which we had to do each day for several weeks. Nobody seems to like these stretches, myself included, but they are the most powerful tool to keep baby’s tongue and lip from reattaching.

Mama Tip: Make it fun?! I used to dread doing the stretches and was dead-serious and stressed. If I had my time again I’d completely reframe my mindset about these stretches and adopt the approach of Melissa Cole from Luna Lactation. I’m less focused on the technical aspect of the stretches here, but rather on her general approach and attitude. Melissa turns the stretches into a fun game, constantly engaging and talking to the baby.

Consider your timing. Some babies cry, but settle right down if they get fed after the stretches. Others, get too worked up to get a good feeding in afterwards. Work whatever approach works for you.

3. Lactation Consultant

Arm yourself with the contact of a lactation consultant confident in tongue tie, so you know who to call right away should breastfeeding continue to be a struggle.

Choose your lactation consultant wisely. Ask your tongue tie revision provider for a referral or do a quick interview with the lactation consultant over the phone, asking how frequently she works with babies’ post tongue tie release.

4. Laid Back Breastfeeding

Many moms miss the memo here. The most powerful aspect of this position, especially for babies post frenotomy, is that it encourages a deep latch along with a more graduate milk flow. Allowing your baby to be in control of the milk flow, and providing a better opportunity for your baby to improve his own “suck-swallow-breath” pattern.

Laid back breastfeeding can seem awkward and almost unnatural. Perhaps because we’ve been preconditioned to think of breastfeeding as sitting upright and holding baby in a cradle position as most often depicted. My first attempt involved my baby crying for 15 minutes straight, before latching in this position. Doesn’t sound like much? Well, those 15 minutes of crying felt like 150 minutes to me! I never would have managed to stay calm and give my baby the time he so desperately needed without the support of my lactation consultant.

This remains my go-to breastfeeding position to this day, as my little man turns one. Well, it’s more like the “toddler version”, where he climbs on top of me and helps himself to the goods.

5. Bodywork

Tongue tied babies can suffer from tight tongue, mouth, face, and neck muscles, even after the release. Bodywork can help loosen up your baby’s muscles and help mobilize the neck, mouth and tongue. There are many different types of bodywork to choose from, including: gentle chiropractic, craniosacral therapy, myofascial therapy, osteopathic treatment and other soft tissue therapies.

Again the important thing here is the experinece your practitioner has with tongue and lip ties in babies. To find a provider near you, check out this website and ask the provider how frequently she/he works with babies after a tongue or lip tie release.

Many moms swear that bodywork is an important piece to the tongue tie puzzle. Rather than adopting a “wait and see” approach, I would recommend setting up an appointment for bodywork to be done a day or so after the procedure.

6. Avoid The Tongue Tie Booby Trap

I want to warn you about one common mistake, that most moms tend to make. Myself included the first time around.

Moms tend to get their hopes up about being able to breastfeed effortlessly right after the revision without any additional help.Some babies may nurse perfectly right away, but many babies, especially older ones, will need more time and some help along the way.

These babies need to literally learn how to use their newly mobilized tongue. Think about someone who has been in a wheelchair, unable to walk for some time. Then after a surgery, the person regains the ability to walk again. That doesn’t mean he’ll jump out of the wheelchair and start sprinting! No, it takes practice and training to get coordinated and to rebuild the leg muscles. It’s very similar for your baby’s tongue. Your baby may need to learn how to suck in a completely different way. Older babies tend to take longer to learn this than babies who get revised within days of birth. One lactation consultant explained it this way: “If your baby is only 2 weeks old, it may only take him around 2 weeks after the procedure to learn how to nurse well. On the other hand, if your baby is already 2 months old, it may take closer to 2 months to drop the “bad” sucking habits and get on the right track.”

It all varies, and there are no hard and fast rules. So, if your baby doesn’t nurse like a champ right after the procedure, don’t be discouraged! Give yourself the credit you deserve – take it from me you’re doing an amazing job mama!

7. Second Opinion

All too often, I hear of moms, who see no improvements even weeks after the procedure, despite seemingly doing everything right!

Incomplete tongue tie release: where the “submucosal”, or “posterior” component of a tongue tie is missed is all too common. As is only releasing either the lip tie or tongue tie.

When the emotional rollercoaster ride to get a tongue tie released doesn’t pay off with visible feeding improvements it is completely gut wrenching. At this point, mothers often dismiss the tongue tie issue, because well it’s been sorted already! They start searching for different answers, and get completely sidetracked from the real issue. Meanwhile, the clock keeps ticking, baby struggles to feed, and breastfeeding slowly starts slipping away. Moms often find out about this after finally getting a second opinion from a different provider.

MamaTip: If in doubt SHOUT, get that second opinion, trust your instinct.

Be sure to ask your provider about treatment for posterior tongue ties. A thorough understanding of this concept, rather than a blank, confused look on your provider’s face is what you want. Sometimes the submucosal or posterior tongue ties are “isolated” and completely hidden, making it look like there’s no tongue tie at all! Baby’s tongue just appears short, without any visible frenulum at the bottom. The only way to get these sneaky buggers to reveal themselves is through a quick, physical test.

If your provider tells you that there is only a lip tie, but no tongue tie, alarm bells need to go off inside your head. Unless, you are 100% certain of your provider's knowledge about ties and you trust him 100%, don’t allow him to only release one or the other. Only releasing a lip tie without releasing a tongue tie, often leaves babies with nothing to help them compensate and breastfeeding goes downhill quickly from there. So, be sure that both tongue and upper lip get thoroughly examined and addressed. A good starting point for finding a provider can be found here.

Finally, you’ve likely gone through a LOT trying to breastfeed or bottle feed your baby. Just finding out why your baby has been struggling may have been a rough road. You’ve likely been failed by several health professionals who should be providing support. Remember to be kind to yourself, mama. Never feel like you are in this on your own, because there are many moms like us. More importantly, never feel like you should just be able to figure all this out on your own. Ask for help and be diligent in choosing your helpers. There is so much hope and so much to look forward to for you and your little one.